Rabbi Ratzon Arusi, the municipal rabbi of Kiryat Ono and a member of the
Council of the Chief Rabbinate, has proposed a radical new approach to the issue
of organ donation.

Instead of requiring the consent of a potential donor
or their family, the decision would be put in the hands of rabbinical courts
that would establish whether or not the potential donor has died and thereby
determine when to allow a hospital to remove the useable organs.

Arusi
laid out his ideas in Tchumin, an annual publication produced by Machon Tzomet
on issues concerning Jewish law in conjunction with contemporary matters of
science, society and the state.

According to Arusi’s proposals, the
rabbinate would establish rabbinical courts in every hospital, which would deal
with every case of potential organ donors.

The court would establish when
“irreversible damage” to the brain stem has occurred, a status accepted by many
rabbis as the halachic definition of death, and the hospital would then
recommend whether or not to remove the organs for transplant.

The state
considers brainstem death to be actual death for all legal and other
purposes.

Most rabbis agree that this definition is in accordance with
Jewish law, although some in the ultra-Orthodox community – including Rabbi
Yosef Shalom Elyashiv, the leading figure of the haredi community – argue that
cardiac death is the defining criteria.

Israel has a low rate of organ
donation compared to other Western countries, although numbers have been
increasing as of late.

According to the Global Observatory on Donation
and Transplantation, Israel’s rate of transplanted organs in 2010 was 31 per
million people, compared to 91 in Austria, 90 in the US, 72 in France, 64 in the
UK and 62 in Germany. Jordan, Iran and Turkey all have higher rates than Israel.
However, a 60- percent increase in Israeli organ donation was recorded in
2011.

According to Arusi’s plan, the rabbinical courts would be able to
remove organs for donation even if the deceased had never signed a organ donor
card and even if the family of the deceased objects. They would also ensure that
the organ removal be conducted respectfully and that the deceased be taken for
burial immediately, he said.

According to the rabbi, who also serves as
the representative of the Chief Rabbinate on the steering committee of the
National Transplant Center, when a patient’s life is in danger, it is
halachically permissible to transplant organs from a deceased person in order to
save the endangered patient’s life, and a rabbinical court has the ability and
authority to rule on the issue.

“One must be extremely careful about the
commonly held view that a man is the owner of his own body,” Arusi
said.

“Using this kind of viewpoint, people permit many things that are
forbidden by Jewish law, like suicide, selfharm, high-risk sports and
activities, and euthanasia,” he continued.

“The assumption that a man is
master of his own life is problematic, because in fact it is a gift from the
creator and he is the one who decides how and when life ends.”

Robby
Berman, founder and director of the Halachic Organ Donor Society, said that
despite the positive intentions of Arusi to deal with the low number of organ
donations in Israel, he would not encourage a rabbinical court to overrule a
family’s wishes for dealing with a loved one.

He added that an opt-out
system, whereby a presumption is made that someone is an organ donor unless they
specifically state they do not want to do so, has similar problems to those of
Arusi’s proposal.

Several countries such as Spain, Austria and Sweden
have instituted opt-out policies assuming consent for organ donation by every
citizen unless they declare otherwise.

“If someone has signed an
organ-donor card, then in the overwhelming number of cases, a family will
respect that decision, even if they’re uncomfortable with it,” Berman
said.

“But without that kind of agreement, families can argue against the
decision to use their loved one’s organs.”

Berman stressed that the best
way to improve organdonor figures in Israel was for better education and for
political and religious public officials to speak out on the issue.

He
added that, in his opinion, MKs, ministers and prime ministers should all be
required to sign donor cards.

“If public officials don’t have the basic
sense of civil duty to become organ donors, then they shouldn’t be running for
office,” Berman said.